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1.
The impact of hydrosalpinx (HSPX) on in-vitro fertilization (IVF) outcome
has recently been the subject of intense debate. Most, but not all, studies
have reported decreased implantation and pregnancy rates and increased
early pregnancy loss in HSPX patients. This has led to prophylactic
salpingectomies prior to IVF in HSPX patients despite the lack of any
prospective studies to suggest that any improvement will occur. Women with
HSPX constitute a heterogeneous population because some conceive easily
with IVF while others do not until after surgical correction. HSPX also
increases in size with ovarian stimulation, and can cause implantation
failure by fluid reflux into the uterine cavity. Careful assessment of the
endometrial lining is mandatory in HSPX to rule out fluid reflux from the
HSPX. We present two case reports of patients whose HSPX enlarged with
ovarian stimulation, causing fluid reflux into the uterine cavity which was
only noted after human chorionic gonadotrophin (HCG) administration.
相似文献
2.
Intraoperative suspicion of gallbladder carcinoma in laparoscopic surgery: what to do? 总被引:5,自引:0,他引:5
The frequency of gallbladder cancer in Europe is less than 1% of all gallstone operations. With the introduction of laparoscopic surgery and the higher acceptance of this technique, patients with gallstones have gallbladder removal much earlier in their gallstone history. So the percentage of gallbladder carcinomas will decrease in the future. We report on our surgical procedures in patients with suspicious gallbladders having laparoscopic gallbladder removal, and how to proceed after the diagnosis of gallbladder carcinoma. From June 1990 to December 2001, we have performed 7,130 cholecystectomies in a single department. 47 of these patients (0.66%) were identified as having carcinoma. There were 40 females and 7 males, with a mean age of 70.6 years. In 17 cases (36%) there was a preoperative suspicion of malignancy. Most commonly, in 30 cases (64%), malignancy was suspected intraoperatively or diagnosed postoperatively after pathological examination of the resected gallbladder. We recommend removal with a bag for all gallbladders with a suspected wall or scleroatrophic calcified gallbladder area. In stage Tis or T1 laparoscopy + cholecystectomy is sufficient. For T2 and T3 we perform reoperation with liver bed resection and lymphadenectomy. 相似文献
3.
The glyoxylate cycle, which is well characterized in higher plants and some microorganisms but not in vertebrates, is able
to bypass the citric acid cycle to achieve fat-to-carbohydrate interconversion. In this context, the hydrodynamic transfer
of two glyoxylate cycle enzymes, such as isocytrate lyase (ICL) and malate synthase (MS), could accomplish the shift of using
fat for the synthesis of glucose. Therefore, 20 mice weighing 23.37 ± 0.96 g were hydrodinamically gene transferred by administering
into the tail vein a bolus with ICL and MS. After 36 hours, body weight, plasma glucose, respiratory quotient and energy expenditure
were measured. The respiratory quotient was increased by gene transfer, which suggests that a higher carbohydrate/lipid ratio
is oxidized in such animals. This application could help, if adequate protocols are designed, to induce fat utilization for
glucose synthesis, which might be eventually useful to reduce body fat depots in situations of obesity and diabetes. 相似文献
4.
Prof. Dr. C. Burri FI. Henkemeyer Th. Rüedi 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1971,330(1):54-78
Zusammenfassung Die unhappy triad der Knochenchirurgie, Infekt, Defekt und Instabilität stellt uns auch heute noch vor schwer zu lösende Probleme. Das Vorgehen der Wahl scheint uns die Stabilisierung der Fragmente mittels einer internen (Osteosynthese) oder externen (äußere Spanner) Fixation, die radikale Ausräumung des Herdes, die vorübergehende Spüldrainage nach Willenegger [26, 27, 28] und schließlich das Auffüllen des Defektes mit autologer Spongiosa zu sein. Bei allen unseren in dieser Studie erfaßten 25 Patienten kam es zum knöcherner Einbau des Transplantates und Abheilung des Haut- und Weichteildefektes, bei vier Patienten be schleunigte eine Spalthautverpflanzung die Heilung. 23 Fälle sind 1 bis 6 Jahre nach der Behandlung vom Infekt her rezidivfrei geblieben, bei sämtlichen Patienten konnte die Belastungsstabilität erreicht werden.Durch das beschriebene Vorgehen konnte in allen Fällen die Gelenkfunktion erhalten oder verbessert werden. Das aktive Eingreifen gestattet zudem Achsen- und Längenkorrekturen.Klinische, szintigraphische und histologische Untersuchungen zeigen, daß der Einbau des spongiösen Transplantates unmittelbar nach der Verpflanzung einsetzt und nach 3 Monaten soweit fortgeschritten ist, daß die Belastungsstabilität erreicht wird.
Autogenous cancellous bone in osteomyelitis with defects of bone, soft tissue and skin
Summary Surgeons are still confronted with the grave problem of the unhappy triad of bone surgery, i.e. infection, osseous defect and instability. To us the stabilisation of fragments by means of internal or external fixation, the radical saucerization and packing of the cavity with autogenous cancellous bone with preceding irrigation drainage seems to be the procedure best suitable. 25 patients with infected defects of bone, soft tissue and skin were treated accordingly and followed up 1 to 6 years later: In all cases the graft had been integrated and the skin- and soft tissue defects had healed. In 23 cases osteomyelitis had not re-occured, weight bearing stability had been achieved in all 25 cases.The described procedure had either maintained or even improved articular function. Additionally the active intervention allowes correction of axis and length.It is demonstrated by radiological, scintigraphical and histological examinations, that the integration of the cancellous bone transplant begins immediately after transplantation and is advanced within three months to such a point that weight bearing becomes possible.相似文献
5.
H. G. Beger E. Kraas R. Bittner 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1980,352(1):307-310
Zusammenfassung Der Endotoxinschock ist die häufigste Form des septischen Schocks. Endotoxin, ein makromolekulares Lipopolysaccharid wird beim Zerfall aus der Zellwand der gramnegativen Keime freigesetzt. Bei Patienten mit bakterieller Peritonitis sind: Fieber über 38°C, Thrombocytopenie, Leukocytose, Lactacidose, Kreatininanstieg hinweisende Zeichen. Die Frühlaparotomie ist bei bakterieller Peritonitis der entscheidende Schritt zur Vermeidung eines Endotoxinschocks. 相似文献
6.
PURPOSE: Approximately 5 to 10% of parathyroid adenomas are located within the thin, fibrous capsule of the thyroid gland. These subcapsular adenomas can complicate minimally invasive parathyroidectomy. The small incision used in this procedure limits the view of the surgical bed. Palpation is less sensitive when the adenoma is covered by the thyroid capsule. If a subcapsular parathyroid adenoma can be identified on preoperative parathyroid scintigraphy, nuclear medicine physicians can recommend exploration of the thyroid capsule early, leading to an easier, more efficient operation. The objective of this observational study was to identify the scintigraphic appearance of subcapsular parathyroid adenomas. MATERIALS AND METHODS: A total of 109 patients with primary hyperparathyroidism underwent preoperative dual-phase Tc-99m sestamibi parathyroid scintigraphy at our tertiary care center from October 2002 to March 2004. Tc-99m pertechnetate was used as a supplemental technique when deemed necessary for optimal interpretation. Retrospective chart review identified 16 surgically proved subcapsular parathyroid adenomas. Parathyroid scintigraphy was reviewed. RESULTS: Subcapsular parathyroid adenomas tend to conform to the expected shape of the thyroid gland. In this small series, subcapsular parathyroid adenomas followed 1 of 3 patterns on lateral images: (1) focal convex distortion of the posterior wall of the thyroid, (2) polar lentiform configuration, and (3) compression of the posterior thyroid parenchyma. CONCLUSION: Subcapsular parathyroid adenomas often have a distinct appearance on scintigraphy. Preoperative identification of this type of parathyroid adenoma can direct a subcapsular surgical approach, optimizing the efficiency of the minimally invasive parathyroidectomy. 相似文献
7.
Leon Asher Wohlwill Oppenheimer Holthusen Oberniedermayr Buschke W. Fischer Eisner-Behrend Flury Jonas Edens Koenigsfeld Kleinschmidt Erich Langer Versé Lewy Herzfeld Grassheim Weigert Taterka Magnus-Alsleben Deusch Kraas Usadel Schall Vaternahm Gottschalk Schumacher Dietrich Steindorff Bonfils Mendel Friedemann 《Journal of molecular medicine (Berlin, Germany)》1930,9(23):1088-1095
Ohne Zusammenfassung 相似文献
8.
Gruhle Artelt Schübel Koenigsfeld Lewy Weigert Seligmann Deusch W. Fischer Bonfils Kraas O. A. Schwarz Wohlwill Rosenberg Dietrich Jonas Herzfeld Valentin Oberniedermayr Michaelis Sperling Friedemann Riebeling Mendel Loewenberg 《Journal of molecular medicine (Berlin, Germany)》1931,10(26):1229-1235
Ohne Zusammenfassung 相似文献
9.
Elze Wohlwill Taterka Bürgers Lewy Jacobsohn Peiper K. Hirschfeld Seligmann Eckstein Weigert G. Liebermeister Ulrici W. Fischer Griesbach Edens Erich Langer Jonas Kraas Eisner-Behrend Herzfeld Frischen Hübner Hueck Gottschalk Kroetz Enderlen v. Jaschke Schuhmacher Dietrich Friedemann O. Wiener Mendel 《Journal of molecular medicine (Berlin, Germany)》1929,8(27):1272-1281
10.
V. Salle Diepgen Bruno Heymann Lewy Wohlwill Schübel Hecht Oppenheimer Schumacher Frischen Holthusen Halberstaedter H. Braun Finkenrath Mendel Weigert Herzfeld Ulrici Dresel Eisner-Behrend Zinn Deusch Sperling Edens Salinger Deist Sacher Bonfils Taterka Kraas Gottscha>lk Griesbach Buschke jun G. Rosenow H. Hirschfeld Erich Langer Schiff Lange Hauptmann Preuss 《Journal of molecular medicine (Berlin, Germany)》1930,9(49):2314-2324
Ohne Zusammenfassung 相似文献